Celiac disease in children with autoimmune thyroid disease

Larizza, Daniela; Calcaterra, Valeria; Giacomo, Costantino De; Silvestri, Annalisa De; Asti, M.; Badulli, C.; Autelli, Michele; Coslovich, Eliana; Martinetti, Miryam

doi:10.1067/mpd.2001.118189

Cited by 82 publications

(60 citation statements)

References 8 publications

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“…The converse risk for Addison's disease in the population with thyroid autoimmunity has been reported to be 2-3% (31). Somewhat contrary to this hypothesis is the observation that in the general population, the risk for AIT increases for those with celiac disease and vice versa (32)(33). Further studies with larger populations of individuals with type 1 diabetes are needed to answer this basic question about initiation of subspecific groups of autoimmune disease.…”

Section: Statistical Analysesmentioning

confidence: 55%

Autoantibody “Subspecificity” in Type 1 Diabetes

et al. 2005

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OBJECTIVE—Autoimmune thyroid disease (AIT), celiac disease, and Addison’s disease are characterized by the presence of autoantibodies: thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) in AIT, tissue transglutaminase antibody (TTGAb) in celiac disease, and 21-hydroxylase antibody (21-OHAb) in Addison’s disease. The objective of this study was to define the prevalence of these autoantibodies and clinical disease in a population with type 1 diabetes. RESEARCH DESIGN AND METHODS—We screened 814 individuals with type 1 diabetes for TPOAb, TGAb, TTGAb, and 21-OHAb. Clinical disease was defined by chart review. Factors related to the presence of autoimmunity and clinical disease including age at onset of type 1 diabetes, duration of diabetes, age at screening, sex, and the presence of autoantibodies were reviewed. RESULTS—The most common autoantibodies expressed were TPOAb and/or TGAb (29%), followed by TTGAb (10.1%) and 21-OHAb (1.6%). Specific HLA DR/DQ genotypes were associated with the highest risk for expression of 21-OHAb (DRB1*0404-DQ8, DR3-DQ2) and TTGAb (DR3-DQ2- DR3-DQ2). The expression of thyroid autoantibodies was related to 21-OHAb but not to TTGAb. The presence of autoantibodies was associated with and predictive of disease. CONCLUSIONS—In this large cohort of individuals with type 1 diabetes, the expression of organ-specific autoantibodies was very high. The grouping of autoantibody expression suggests common factors contributing to the clustering.

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Section: Statistical Analysesmentioning

confidence: 55%

Autoantibody “Subspecificity” in Type 1 Diabetes

et al. 2005

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“…In this same report, researchers screened 184 patients with celiac disease and diagnosed hypothyroidism in 22 (12%) with 21% positive for antibodies associated with thyroid disease (28). This some observations holds true for pediatrics, in a series of 90 children with autoimmune thyroid disease, 7 (7.8%) were diagnosed with celiac disease after identification of positive EMA and small intestinal biopsy (27).…”

Section: Associated Conditions (Table 1)mentioning

confidence: 93%

“…Given the background prevalence of celiac disease of 1:100, there are populations that are at an increased risk for disease, including patients with type 1 diabetes (26), autoimmune thyroid disease (both hyper-and hypothyroidism) (27,28), relatives of patients with celiac disease (3) and type 1 diabetes and patients with Turner (29,30) and Down syndromes (31). Rates of celiac disease in these populations range from 5-10%.…”

Section: Epidemiology (Table 2)mentioning

confidence: 99%

Celiac Disease: Pathophysiology, Clinical Manifestations, and Associated Autoimmune Conditions

Barker

Liu

2008

Advances in Pediatrics

161

133

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“…Further supportive of a link between these three immune-mediated conditions is the higher prevalence of CD in both T1D and ATD (7)(8)(9)(10).…”

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confidence: 99%

Celiac Disease Increases Risk of Thyroid Disease in Patients With Type 1 Diabetes: A Nationwide Cohort Study

et al. 2015

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OBJECTIVEBoth type 1 diabetes (T1D) and celiac disease (CD) have been linked to autoimmune thyroid disease (ATD). We examined if individuals with both T1D and CD were at a higher risk of ATD than those with only T1D. RESEARCH DESIGN AND METHODSThis study was a nationwide population-based cohort study. We defined T1D as having an inpatient or a hospital-based outpatient diagnosis of T1D at age £30 years in the Swedish National Patient Register between 1964 and 2009. Data on CD were obtained through small intestinal biopsy reports showing villous atrophy (Marsh histopathology grade III) between 1969 and 2008 at any of the 28 pathology departments in Sweden. ATD included hyperthyreosis and hypothyreosis, defined according to the Swedish National Patient Register. We identified 947 individuals with T1D and biopsy-verified CD. These were matched to 4,584 control subjects with T1D but no CD diagnosis. Cox regression then estimated the risk of ATD. RESULTSAmong T1D, CD was a risk factor for later ATD. During follow-up, 90 T1D+CD patients developed ATD (expected n = 54). Adjusting for sex, age, and calendar period, this corresponded to a hazard ratio (HR) of 1.67 (95% CI 1.32-2.11; P < 0.001). This excess risk was highest in those who had CD for 10 years or more (HR 2.22 [95% CI 1.49-3.23]). Risk increases were seen in both males and females. CD was a risk factor for both hypothyreosis (HR 1.66 [95% CI 1.30-2.12]) and hyperthyreosis ). CONCLUSIONSAmong patients with T1D, CD is a risk factor for the later development of ATD.Celiac disease (CD) is an immune-mediated enteropathy that has a prevalence of 1% in Western populations (1). It occurs in genetically susceptible individuals after exposure to dietary gluten, which is a protein found in wheat, barley, and rye. Strict adherence to a gluten-free diet is the mainstay of treatment for CD, which reduces the risk of developing serious complications such as lymphoma, osteoporosis, hyposplenism, anemia, and other micronutrient deficiencies (2). CD has been linked to both type 1 diabetes (T1D) and autoimmune thyroid disease (ATD) (3,4). The development of autoimmune conditions in CD may be related to the duration of gluten exposure, although previous findings from the literature are conflicting (5,6).

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Celiac disease in children with autoimmune thyroid disease

Cited by 82 publications

References 8 publications

Autoantibody “Subspecificity” in Type 1 Diabetes

Autoantibody “Subspecificity” in Type 1 Diabetes

Celiac Disease: Pathophysiology, Clinical Manifestations, and Associated Autoimmune Conditions

Celiac Disease Increases Risk of Thyroid Disease in Patients With Type 1 Diabetes: A Nationwide Cohort Study

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